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Conclusions: Acute or chronic RI was present in 9% of patients with ACVD. RI was associated with significantly greater risks of in-patient mortality, LOS, and discharge to a facility. In subgroup analyses, the overall HC were greater in patients with acute RI. Patients undergoing HD experienced a similar negative impact on all outcome parameters except for disposition status. The negative impact of RI on vital outcome parameters in ACVD patients should be considered, i.e., when indicating the administration of contrast for imaging.